Neonatal Nurse Practitioner Practice Exam

What effect does bicarb have on sodium levels in neonates?

1. Increases sodium levels

2. Decreases sodium levels

3. Has no effect on sodium levels

4. Stabilizes sodium levels

The correct answer is: Decreases sodium levels

Bicarbonate does influence sodium levels in neonates, primarily through its role in correcting metabolic acidosis. When bicarbonate is administered, it can lead to a transient decrease in sodium concentration due to shifts in fluid and electrolyte balance. When bicarbonate is infused, it increases the bicarbonate concentration in the blood. This can lead to a dilutional effect, wherein the overall sodium concentration may decrease as a consequence of the movement of fluid and electrolytes. Additionally, in response to changes in acid-base status, the kidneys may also adjust the excretion and reabsorption of sodium, which can further impact sodium levels. Thus, the administration of bicarbonate can be associated with decreased sodium levels in neonates as a result of these metabolic and physiological responses. This understanding is crucial for the management of neonates, especially those with conditions that may result in acidosis, as it informs both the assessment and treatment of electrolyte imbalances.